SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2012
Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 995 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bright Light Therapy Efficacy for Depressive Symptoms Following Cardiac Surgery or Acute Coronary Syndrome: Pilot Trial
Addressing Stress Responses on the Frontline-Further Development of RESTORE (Recovering From Extreme Stressors Through Online Resources and E-health)
RESTORE: An Online Self-directed Mental Health Intervention for Individuals Who Had COVID-19 and Close Others
Prevention of Mental Health Problems Among Persons Without Personal Housing in the Context of the COVID-19 Epidemic: a Randomized Controlled Trial
KINCISE™ Surgical Automated System in Total Hip Arthroplasty (THA)
Sleep Disturbance in MCI: A Pilot Study of a Cognitive Behavioural Therapy Digital Intervention (SUCCEED)
Depression Among Cardiothoracic Patients in Baghdad: A Cross-Sectional PHQ-9 Study
Who cites it
995 citing papers in PubMed, 1 synthesis or guideline pooled it, 1,946 citations in OpenAlex.
- Pooled it
- An examination of core beliefs in generalized anxiety disorder.The British journal of clinical psychology · 2026Trial
- Trial
- Cognitive Behavioral Therapy for Individuals With Low Literacy and Perinatal Depression: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Digital cognitive behavioral therapy versus Education for chronic pain in adults with sickle cell disease: 12-month randomized trial results.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2026Trial
- Effect of AI-Based Natural Language Feedback on Engagement and Clinical Outcomes in Fully Self-Guided Internet-Based Cognitive Behavioral Therapy for Depression: 3-Arm Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Longer-term effects of modernized collaborative care for depression on multiple mental health factors (eIMPACT): A randomized controlled trial.Journal of affective disorders · 2026Trial
- Patterns of Engagement With the mHealth Component of a Sexual and Reproductive Health Risk Reduction Intervention for Young People With Depression: Latent Trajectory Analysis.JMIR mHealth and uHealth · 2025Trial
- Impact of a Digital Decision Aid When Choosing Between Face-to-Face and Guided Internet-Based Psychological Interventions for Depression Among Chinese-Speaking Participants in Hong Kong: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- The effect of vitamin D supplementation on mental and functional health outcomes in African Americans with type 2 diabetes.The Journal of steroid biochemistry and molecular biology · 2025Trial
- Six-Week Problem Area-Concordant vs 8-Week Problem Area-Discordant Group Interpersonal Psychotherapy: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Cumulative Risk and Cumulative Protection: Relative Contributions to Predicting Substance Use, Antisocial Behaviour and Mental Health Across Development.Criminal behaviour and mental health : CBMH · 2025Trial
- Prefrontal tDCS fails to modulate memory retrieval in younger and older adults.Current biology : CB · 2025Trial
- Depression and weight loss trajectories during an integrated behavioral intervention: Within-treatment analysis of the RAINBOW trial.PloS one · 2025Trial
- The use of abstract animations and a graphical body image for assessing pain outcomes among adults with sickle cell disease.The journal of pain · 2025Trial
- Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial.Rheumatology (Oxford, England) · 2025Trial
- Advancing equity in routine-care internet-delivered cognitive behaviour therapy: Representativeness, outcomes, engagement, and satisfaction.Internet interventions · 2026Article
- Latent profiles of PTSD and CPTSD: the importance of emotional hypoactivation.European journal of psychotraumatology · 2026Article
- Interpretable machine learning for depression symptom classification in NHANES: Performance in a curated high-confidence corpus and the full survey population.IBRO neuroscience reports · 2026Article
- Burden and factors associated with depressive symptoms among adults receiving tuberculosis treatment in South India: A cross-sectional study.Dialogues in health · 2026Article
935 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe brief Patient Health Questionnaire (PHQ-9) is commonly used to screen for depression with 10 often recommended as the cut-off score. We summarized the psychometric properties of the PHQ-9 across a range of studies and cut-off scores to select the optimal cut-off for detecting depression.
methodsWe searched Embase, MEDLINE and PsycINFO from 1999 to August 2010 for studies that reported the diagnostic accuracy of PHQ-9 to diagnose major depressive disorders. We calculated summary sensitivity, specificity, likelihood ratios and diagnostic odds ratios for detecting major depressive disorder at different cut-off scores and in different settings. We used random-effects bivariate meta-analysis at cutoff points between 7 and 15 to produce summary receiver operating characteristic curves.
resultsWe identified 18 validation studies (n = 7180) conducted in various clinical settings. Eleven studies provided details about the diagnostic properties of the questionnaire at more than one cut-off score (including 10), four studies reported a cut-off score of 10, and three studies reported cut-off scores other than 10. The pooled specificity results ranged from 0.73 (95% confidence interval [CI] 0.63-0.82) for a cut-off score of 7 to 0.96 (95% CI 0.94-0.97) for a cut-off score of 15. There was major variability in sensitivity for cut-off scores between 7 and 15. There were no substantial differences in the pooled sensitivity and specificity for a range of cut-off scores (8-11).
interpretationThe PHQ-9 was found to have acceptable diagnostic properties for detecting major depressive disorder for cut-off scores between 8 and 11. Authors of future validation studies should consistently report the outcomes for different cut-off scores.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.